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United States,

TREATMENT AND CARE FOR PERSONS WITH

HIV INFECTION AND AIDS

HEARINGS

BEFORE THE

HUMAN RESOURCES AND INTERGOVERNMENTAL

RELATIONS SUBCOMMITTEE

OF THE

COMMITTEE ON
GOVERNMENT OPERATIONS
HOUSE OF REPRESENTATIVES

ONE HUNDRED FIRST CONGRESS

FIRST SESSION

JULY 28 AND AUGUST 1, 1989

Printed for the use of the Committee on Government Operations

U.S. GOVERNMENT PRINTING OFFICE

22-690

WASHINGTON : 1990

For sale by the Superintendent of Documents, Congressional Sales Office

U.S. Government Printing Office, Washington, DC 20402

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JOHN CONYERS, JR., Michigan, Chairman CARDISS COLLINS, Illinois

FRANK HORTON, New York GLENN ENGLISH, Oklahoma

WILLIAM F. CLINGER, JR., PENNSYLVANIA HENRY A. WAXMAN, California

AL MCCANDLESS, California TED WEISS, New York

HOWARD C. NIELSON, Utah MIKE SYNAR, Oklahoma

DONALD E. "BUZ" LUKENS, Ohio STEPHEN L. NEAL, North Carolina

J. DENNIS HASTERT, Illinois DOUG BARNARD, JR., Georgia

JON L. KYL, Arizona BARNEY FRANK, Massachusetts

CHRISTOPHER SHAYS, Connecticut TOM LANTOS, California

PETER SMITH, Vermont ROBERT E. WISE, JR., West Virginia

STEVEN SCHIFF, New Mexico BARBARA BOXER, California

CHUCK DOUGLAS, New Hampshire MAJOR R. OWENS, New York

LARKIN I. SMITH, Mississippi
EDOLPHUS TOWNS, New York

C. CHRISTOPHER COX, California
JOHN M. SPRATT, JR., South Carolina CRAIG THOMAS, Wyoming
JOE KOLTER, Pennsylvania
BEN ERDREICH, Alabama
GERALD D. KLECZKA, Wisconsin
ALBERT C. BUSTAMANTE, Texas
MATTHEW G. MARTINEZ, California
NANCY PELOSI, California
DONALD M. PAYNE, New Jersey
JIM BATES, California

JULIAN EPSTEIN, Staff Director
DONALD W. UPSON, Minority Staff Director

HUMAN RESOURCES AND INTERGOVERNMENTAL RELATIONS SUBCOMMITTEE

TED WEISS, New York, Chairman HENRY A. WAXMAN, California

LARKIN I. SMITH, Mississippi NANCY PELOSI, California

PETER SMITH, Vermont DONALD M. PAYNE, New Jersey

Ex OFFICIO
JOHN CONYERS, JR., Michigan

FRANK HORTON, New York
JAMES R. GOTTLIEB, Staff Director
PATRICIA S. FLEMING, Professional Staff Member

PAMELA H. WELCH, Clerk
WAYNE CIMONS, Minority Professional Staff

(11)

90-621117

CONTENTS

Hearings held on:

Page

July 28, 1989

1

August 1, 1989.

221

Statement of:

Arno, Peter S., Ph.D., health economist, department of epidemiology and

social medicine, Montefiore Medical Center, Albert Einstein College of

Medicine..

16

Brown, Lawrence S., Jr., M.D., M.P.H., senior vice president for research

and medical affairs, Urban Resource Institute, Addiction Research and

Treatment Corp.

66

Christen,
Pat, acting executive director, San Francisco AIDS Foundation ..

169

Craven, Donald E., M.D., director, clinical AIDS programs, Boston City

Hospital..

133

El-Sadr, Wafaa, M.D., chief, infectious disease section, Harlem Hospital

Center

116

Jellinek, Paul S., Ph.D., senior program officer, the Robert Wood Johnson

Foundation....

90

Mason, James O., M.D., Assistant Secretary for Health, Department of

Health and Human Services, accompanied by Dr. Samuel C. Matheny,
Associate Administrator for AIDS, Health Resources and Services Ad-
ministration; Dr. Edward D. Martin, Director, Bureau of Health Care
Delivery and Assistance, Health Resources and Services Administra-
tion; Dr. Anthony S. Fauci, Director, National Institute of Allergy and
Infectious Diseases, National Institutes of Health; Dr. Frank Young,
Commissioner, Food and Drug Administration; Dr. Ellen C. Cooper,
Director, Division of Antiviral Drug Products, Office of Drug Evalua-
tion, Center for Drug Evaluation and Research, Food and Drug Admin-
istration; and Elmer Smith, Director, Office of Eligibility Policy,

Bureau of Policy Development, Health Care Financing Administration.. 237
McGuire, Jean F., executive director, AIDS Action Council

188
Overrocker, John Page, accompanied by Bill Ceyrolles, social worker,
Whitman-Walker Clinic.

5
Rango, Nicholas, M.D., director, AIDS Institute, New York State Depart-
ment of Health..

153

Scott, Cornell, executive director, Hill Health Center, New Haven, CT. 198

Smith, David, M.D., medical director, community oriented primary care,

Parkland Memorial Hospital, Dallas, TX..

124

Volberding, Paul A., M.D., associate professor of medicine, University of

California, San Francisco, CA, and chief, AIDS program, San Francisco
General Hospital.....

223
Weiss, Hon. Ted, a Representative in Congress from the State of New

York, and chairman, Human Resources and Intergovernmental Rela-
tions Subcommittee: Opening statement.

1

Letters, statements, etc., submitted for the record by:

Arno, Peter S., Ph.D., health economist, department of epidemiology and

social medicine, Montefiore Medical Center, Albert Einstein College of

Medicine: Prepared statement.

18-65

Brown, Lawrence S., Jr., M.D., M.P.H., senior vice president for research

and medical affairs, Urban Resource Institute, Addiction Research and

Treatment Corp.: Prepared statement

70-89

Christen, Pat, acting executive director, San Francisco AIDS Foundation:

Prepared statement.

172-187

Craven, Donald E., M.D., director, clinical AIDS programs, Boston City

Hospital: Prepared statement..

137-144

(III)

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